Chapter 09: The Office of Global Business Development: A First Partnership in Banner, Arizona

Chapter 09: The Office of Global Business Development: A First Partnership in Banner, Arizona

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Description

In this chapter, Ms. Hay talks about her role in administering the negotiations and implementation process that resulted in a co-branded partnership with MD Anderson Banner, Arizona. She explains the process of reviewing the cancer center and lists the challenges of overcoming institutional differences that could prevent a full offering of MD Anderson quality care. She describes how these challenges resulting led to the service growing the service piece-by-piece, by subspecialities. She notes that MD Anderson required that Banner employ their physicians to take financial interest out of the equation of providing cancer care. She explains why this was a challenge and how it was resolved. She explains how the program came together to form a solid partnership.

Identifier

HayAC_01_20150204_C09

Publication Date

2-4-2015

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center - Building the Institution; The Administrator; Institutional Processes; The Business of MD Anderson; Building/Transforming the Institution; Leadership; MD Anderson Culture; Entrepreneurs, Biotechnology; Beyond the Institution; Global Issues –Cancer, Health, Medicine

Transcript

Amy Carpenter Hay:

Yeah, and maybe that’s a good segue. So, while all this was happening, the Global Business Development Office, which I was part of, was tasked with looking nationally. So, while we were busy building relationships in consulting in Turkey and São Paulo and other places, administration had come back to us and said, “Okay, you clearly know how to do this. So why are we not extended our reach across all of cancer on a national basis?” And that is when we first started engaging with Banner in Arizona.

Tacey Ann Rosolowski, PhD:

Okay.

Amy Carpenter Hay:

Again, we approached it in a similar fashion. We kind of did consulting and a development agreement, and went in, and reviewed everything from top to bottom. We looked at their market. We looked at their financials. We sent teams of clinicians to go in the ORs [operating rooms] and watch cases; to talk to medical oncologists about order sets; to go into the radiation centers and look at the quality indicators on the machines; everything, A to Z. And wrote a formal report on, “Here’s everything that you do today, and here’s everything that you would do if you were MD Anderson. And there’s the gap. And here’s how, together, we could fill the gap.” That led us to, I think, what you’re alluding to, which—there are always areas that can’t possibly be exactly the same. And that’s tough. That’s tough sometimes, because we at MD Anderson like to believe that the only way to do it is the way that we do it. And sometimes that’s the case, but sometimes there’s another way to do it that gets you to the same outcome. And I think part of the challenge, and maybe what you’re hitting on, is that from a business-development-expansion perspective, part of what I have to do every day is talk to folks about how do we get to the right place. And it may be that the road is a little bit different than it has been at 1515 Holcombe. And that’s okay. And that’s an interesting conversation. And it takes time, and it also takes time to prove it. And that almost goes back to the Bellaire treatment center. No one believed it until we proved it, but we proved that the quality and the patient outcomes were equal to that which we have on Main Campus. If we can do that ten miles away, and we can do that over an ocean in Turkey, surely we can do that in Arizona. And that became the discussion point. Because there are differences. Arizona is a great example. That was my first, what we call now, “partner member.” So, a co-branded facility that I negotiated with my partner, and really implemented that center. You know, that’s when I got involved, and became close friends, confidants. She’s a mentor to me in many capacities, with Dr. Maggie [Margaret] Row. I don’t know if you’ve met Maggie yet—

Tacey Ann Rosolowski, PhD:

Uh-uh.

Amy Carpenter Hay:

—but she’d be an excellent, excellent person. Maggie was the clinical lead on Banner. She is an Emergency Medicine doctor here at MD Anderson. She also went back and got her MBA [Master of Business Administration]. So not only does she have the business, but she clearly has the clinical. I often tease her that every Thursday she works in the OR—our ER [emergency room], excuse me. And I always tell her that, you know, that’s her day to be a doctor. The rest of the time [laughs] she’s gotta work with me. She is fantastic. But we worked together to implement that facility. At that location, they had to build from scratch, because we all agreed that their current infrastructure was really not conducive to multidisciplinary care. They didn’t have big clinics. They didn’t have—they had a very traditional, old-school, acute-care hospital. They had multiple of them, but it wasn’t conducive to a cancer center. We couldn’t put everything together and treat patients in the way that we wanted to. Because of this, it took us three years to build a new outpatient cancer center there with them. And we spent those three years recruiting literally every single doctor to the program, setting up the program. But to your point about differences, because we were starting that program from scratch, if you will, it couldn’t possibly start on day one with sub-specialized care in every disease site. We simple don’t have the patients. So, we started it, and it grew organically. You know, we brought some leadership in from Breast Medical Oncology. So, breast skyrocketed, and we were able, within the first year, to have a breast-only clinic. But having some of those sub-specialized disease areas, we had to acknowledge, were—was gonna take time, and recruitment, and volumes. And without the volumes to support, we couldn’t recruit. That was a little different. That was a little bit of a growing pain for us because we were so used to having 35,000 new cancer cases and over 1,000 faculty. Of course, everything should not only be sub-specialized, it should also be sub-sub-specialized. And so, that’s a good example.

Tacey Ann Rosolowski, PhD:

Yeah, yeah.

Amy Carpenter Hay:

Another good example is that, in this situation, we were requiring Banner to employ doctors, because that’s a model of care that we believe in. I know—employing doctors means you take out any potential incentive. It doesn’t matter if you see one or a hundred. It doesn’t matter if the patient is better off having surgery than radiation. It’s a multidisciplinary environment, and it’s something that we, as Anderson, are very committed to, for good reason. Full employment across every specialized area is difficult in a community. It’s hard to employ a neurosurgeon if you only have two neuro cases. It’s hard to employ some of the internal-medicine sectors for only oncology because, generally speaking, a pulmonologist and a cardiologist—they see a lot of different things. They see oncology, but they see different things Because of our volumes here, we have these luxuries that other people don’t. And so, part of our learning was that, in circumstances such as that, we were going to need to go in and review and ensure the quality was there and go a little bit out of our comfort zone. They may not be employed until such a time that we can justify it from a business perspective. So there are subtle differences. I like to think that part of my job and Dr. Row’s job is to get to the right outcome but find creative solutions. And I think we’ve done that well in Banner. Banner, you know, has been in existence now for four years or so. And, you know, I couldn’t be more proud. It’s its own standalone cancer center. It’s already gone to phase two of construction. It started as 125,000 square feet. It’s now over 200. And has really expanded their sub-specialized approach, expanded their clinical trials. They’re working with us on Moon Shots. Really solid, solid partner. The doctors there feel like they are MD Anderson. So, when they go to a conference, they are not Banner. They are Anderson, and they’re treated as such. And that’s the environment that works, based on that relationship and our ability to mature it and grow it.

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Chapter 09: The Office of Global Business Development: A First Partnership in Banner, Arizona

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